Remote Medical Director, Utilization & Rehab Oversight

Humana; United States; Remote; USD 224,000 - 313,000; Full time

Job summary

Humana seeks a Medical Director to remotely authorize post-acute rehabilitation services across the United States. You will interpret clinical data, determine level of care and site of service, and ensure alignment with CMS guidelines and Humana policies.

With 5+ years of direct clinical care, board certification, and active licensure, you will collaborate with care teams, participate in training, and maintain thorough documentation while meeting compliance timelines.

Qualifications

• MD or DO degree required.
• Board certification in ABMS or AOA with continued certification.
• Current and unrestricted license in at least one jurisdiction.

Responsibilities

• Provide medical interpretation and determinations on rehabilitation authorization requests, ensuring CMS and Humana standards.
• Collaborate with teams and leadership to support the review process and quality outcomes.
• Participate in training programs and apply strong documentation and decision-making standards.

Skills

Analytical interpretation

Regulatory compliance

Team collaboration

Communication with physicians

Remote work readiness

Education

MD or DO degree

Board Certified in ABMS or AOA

Job description

Humana seeks a Medical Director to remotely authorize post-acute rehabilitation services across the United States. You will interpret clinical data, determine level of care and site of service, and ensure alignment with CMS guidelines and Humana policies.

With 5+ years of direct clinical care, board certification, and active licensure, you will collaborate with care teams, participate in training, and maintain thorough documentation while meeting compliance timelines.